STRUCTURE: A review of five community hospitals by Surrey Downs Clinical Commissioning Group has set out four options for future community care, which include the closure of two hospitals.

The options are:

  1. Keep inpatient wards at Dorking, Molesey, and New Epsom and Ewell community hospitals. Keep Leatherhead Community Hospital’s inpatient ward closed and develop its planned care services.
  2. Transfer New Epsom and Ewell inpatient services to Epsom and transfer outpatient services elsewhere in the area. Develop Leatherhead’s planned care services.
  3. Transfer Molesey inpatient and outpatient services to Cobham Community Hospital. Develop Leatherhead’s planned care services.
  4. Apply both options two and three, resulting in the closure of two hospitals.

Three of the hospitals currently have inpatient beds. Leatherhead’s inpatient beds were closed in November.

The review team found the inpatient care delivered at the three hospitals was “exceptionally good”, according to a report in the CCG’s September board papers.

All five sites provide outpatient services.

The report says demand for inpatient and outpatient services at the hospitals is expected to increase over the next few years. Surrey Downs’ over-65s account for 20 per cent of the total population. This is expected to increase to 27 per cent by 2025.

The report says it is “widely acknowledged” by the CCG and “wider health community” that the current community bed provision has “some issues which are in need of urgent consideration and review”.

These include:

  • “a lack of consistency in the admissions criteria”;
  • “variable” discharge support arrangements between social care and community services; and
  • hospital estates of “varied quality, with at least one of the sites in need of urgent repairs”.

The review included 20 workshops with the public which 111 people attended and drop-in events with staff at CSH Surrey, the social enterprise that runs four of the hospitals. Cobham is run by private provider Epsomedical.

The report notes that despite advertising the workshops, attendance was “limited”.

The commissioners will also consult on whether to increase the number of rehabilitation beds at New Epsom and Ewell or develop an ambulatory rehabilitation centre model.

Under all options there would be 60 beds, although six of these will only be commissioned if extra capacity is needed.

Several options were discounted including inpatient wards at all four hospitals and closing Leatherhead and Dorking hospitals.

Jill Evans, clinical lead for the review, said: “Over the last four months we have looked at the data, analysed local health needs and the changing needs of our ageing population, considered best practice and talked to patients and staff. We have also looked at the current buildings, both in terms of their condition and any unused capacity that could enable services to be delivered in a different way.

“This has led to a series of recommendations that we believe will improve care, mainly by making the delivery of care even more efficient and streamlined for patients.”